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Its Gotta Be “Right” By The Numbers Potporrui 10 Point 20 Points 30 Points 40 Points 50 Points 10 Point 20 Points 30 Points 40 Points 50 Points 30 Points 40 Points 50 Points Med Rec or Med Wreck The Usual Suspects
Most medication errors resulting in harm are caused by confusing these two drugs
What are Morphine and Hydromorphone? As compiled by the Institute for Safe Medication Practices Canada
This drug tops the list of medications most likely to cause harm as a consequence of a medication error
What is Insulin? As compiled by the Institute for Safe Medication Practices Canada
Three of the top ten drugs most likely to cause harm as a result of a medication error are from this class
What are anti-coagulants ( Heparin,Warfarin, Dalteparin)
This popular antihypertensive isn’t inhibited about being number ten on the list
What is Ramipril? As compiled by the Institute for Safe Medication Practices Canada
Because of its high risk potential, Health Canada recommends disposing this top ten narcotic down the toilet
Fentanyl Transdermal 2005 Public Advisory still on the Health Canada website
Failure to identify this “right” is rarely involved in medication errors reported as causing harm
What is the “right patient” Wrong drug and wrong dose are # 1 and # 2
To obtain the maximum benefit, anti-Parkinson’s drugs should be given with this “right” in mind
The right time
You would have been “right” if you answered 5 to this question before 2008
How many “rights” of safe medication administration are there according to the College of Nurses Now there are 8
After making sure it’s the “right route”, this intramuscular site is the preferred location for most adults
What is ventrogluteal? Dorsogluteal is the least recommended
One of three new “rights” in the updated standards, this is the one least likely to be written in the Doctors’ Orders
What is the right reason? Right frequency and right site are the other two
Dr. House would have no problem breaking into a patient’s medicine cupboard to improve a “BPMH”
What is a Best Possible Medication History He would also have to check with their pharmacy, talk with them and their family, contact any other healthcare providers and or institutions, and check their medication administration record from any other uni t
“ADE”
What is an adverse drug event
According to a recent Quebec study, this percentage of ADE’s are caused by medication “irreconciliation” between hospitals and LTC facilities
What is 20% 95% of
What you have when the physician has made an intentional choice to add, change the dose or route or discontinue a medication and their choice is clearly documented
What is an intentional discrepancy Documented intentional discrepancies are considered best practice in medication reconciliation.
This category of discrepancies accounts for most discrepancies and is generally not considered a “med error”
What are “undocumented intentional discrepancies” An unintentional discrepancy is one in which the physician unintentionally changed the dose or route, added or omitted a medication the patient was taking prior to admission. These are medication errors and can lead to adverse drug events (ADEs)
At 7.5% our rate is better than many, but not better than the rate of every country in the world
What is the percentage of persons admitted to hospital in Canada who will experience an adverse event Worldwide rates are between 2.9 and 16.6
The percentage of patients in a Canadian Hospital who will receive the wrong medication or the wrong dose
What is 1 in 9
Medication errors rank here on the top ten list of causes of death in North America
What is 8 In Canada, medication errors and other hospital related adverse events cause more deaths than MVAs, breast cancer and HIV combined
3300 members of this age group die in Canada each year as a result of a medication error
Who are the Elderly
Of between 4-8, 5-10, 9-13, 10-14, what is number of regularly scheduled medications that residents of LTC facilities take daily
What is 9-13 Remember, many may one day be your patient as well. With PRNs, some take as many as 21different medications as often as 4 times daily
What is Avandia
When it comes to abbreviations, this list is the most important one to know
What is the ISMP “Do NOT Use List”
Of the major categories of infusion pump errors, this one leads the list at 58%
What is incorrect flow rate Over 62% of these are overdose errors
Besides beginning with the letter “G”, garlic, ginseng, gingko biloba, ginger and green tea have this in common
What is interact with Coumadin Decrease INR: Ginseng, green tea, Increases INR: garlic Inhibit platelet aggregation: ginkgo, ginger
This list of medications considered inappropriate for the elderly is named after a doctor and not a popular drink
What is the Beers List? AKA the Beers Criteria, it was first compiled in 1991 and updated in 2003
Make your wager
ISMP CMIRPS Program
What is the national error reporting mechanism that nurses may use to anonymously report medication errors